Guidance for Safeguarding Overweight Children

(0-18 years) in Cornwall

This section is informed by the multi-agency child protection procedures, which have been adopted by the Local Safeguarding children board. See www.swcpp.org.uk.

There may be situations where a child's weight is a safe guarding factor. There is clear guidance within the local procedures that professionals have a statutory duty to follow.

A practitioner should consider using the Common Assessment Framework assessment tool to understand the child’s needs within the broader context of their family and community.

If there are any immediate concerns relating to safe guarding / child protection, practitioners should make an immediate referral to Children’s Social Care on tel: 0300 123 1116.

A review of Childhood Obesity and safeguarding by Dr Russel Viner (BMJ 2010) highlighted the need to recognise obesity as one aspect of safeguarding but not in isolation. However the caveat is if there is a direct and obvious link to ‘obesity associated neglect’ resulting in serious health imminent health concerns to the child. Dr Viner calls for more in dept the research.

Below is a summary statement of the research:

When does obesity become a child protection issue?

16 July 2010 Great Ormond Street Hospital.

With thanks to bmj.com

Childhood obesity alone is not a child protection concern, nor is failure to control weight. But consistent failure to change lifestyle and engage with outside support indicates neglect, particularly in younger children, say experts in a paper published on bmj.com today.

The suggestion that childhood obesity may raise child protection concerns is highly contentious, but there is little published evidence on the issue and no official guidelines for professionals.

So a group of child health experts, led by Dr Russell Viner at the UCL Institute of Child Health in London, set out to review existing evidence and propose a framework for practice.

They found increasing evidence linking adolescent and adult obesity with childhood sexual abuse, violence, and neglect, but found no studies examining the relation between child protection actions and childhood obesity. Data are also lacking on the long term outcomes of child protection strategies in relation to weight control, other metabolic disorders such as diabetes, and psychological health.

In the absence of evidence, the authors suggest that child protection actions are not warranted for childhood obesity alone or failure to control weight. The aetiology of obesity is so complex that we believe it is untenable to institute child protection actions relating parental neglect to the cause of their child’s obesity or to criticise parents for failing to treat it successfully, if they engage adequately with treatment, they write.

However, they do believe that consistent failure by parents to change lifestyle and engage with professionals or with weight management initiatives would constitute neglect. This is of particular concern if an obese child is at imminent risk of disorders like obstructive sleep apnoea, hypertension, type 2 diabetes or mobility restrictions, they say.

Where child protection concerns are raised, the authors suggest that obesity is likely to be one part of wider set of concerns about the child’s welfare. It is therefore essential to evaluate other aspects of the child’s health and wellbeing and determine if concerns are shared by other professionals, they say.

Finally, in cases of severe childhood obesity, they recommend a wider assessment of family and environmental factors.

In all areas of child health, we have a duty to be open to the possibility of child neglect or abuse in any form, they conclude. Guidelines for professionals are urgently needed, as is further research on the outcomes of child protection actions in obesity and links between early adversity and later obesity.